The Substance Use Disorder Treatment Manual provides the regulations, administrative and billing instructions, and service codes for substance use disorder treatment providers. See 130 CMR 450.124 for important information about payment for behavioral health services for MassHealth members. The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. See 101 CMR 346.00.
Each part of the Substance Use Disorder Treatment Manual is listed below from beginning to end. You can print each part separately (or any individual pages) or print all parts for a complete manual.
Table of Contents
- Table of contents pages i, ii, ii-a, and iii appear at the beginning of Subchapter 1 below.
- Table of contents page iv appears at the beginning of Subchapter 4 below.
- Table of contents page v (PDF)
- Table of contents page vi (PDF)
Subchapters 1 through 3: Administrative and Billing Regulations
Subchapter 5: Administrative and Billing Instructions
For instructions for electronic billing, refer to the MassHealth Companion Guides. For instructions for billing MassHealth using paper claim forms refer to MassHealth Billing Guides for Paper Claim Submitters.
Please Note: These instructions are for billing services directly to MassHealth. See 130 CMR 450.124 for important information about payment for behavioral health services for MassHealth members.
The Administrative and Billing Instructions are divided into seven parts.
- Part 1. Eligibility (PDF)
- Part 2. Prior Authorization (PDF)
- Part 3. Billing MassHealth (PDF)
- Part 4. Required Forms and Documentation (PDF)
- Part 5. Claim Status and Payment (PDF)
- Part 6. Claim Status and Correction (PDF)
- Part 7. Other Insurance (PDF)
This information is provided by MassHealth.